What is a Quick Rise in PSA?

Posted by spaceguy @spaceguy, Jun 19, 2024

I've scanned through quite a few of these topics, but didn't come across any yet that seemed too similar to my situation so I wanted to describe my situation and ask the community. I plan to follow up with my PCP for medical advice when I get my retest results and will follow up with my Urologist if the retest comes back the same, just looking for thoughts and maybe pointers to good information while I wait for the results.

I am 55, I have had BPH for a number of years now, over 10 for sure. But my PSA value has never been high due to that BPH, so it would be odd for it to trigger a high value now. I was steadily 0.6 to around 0.75 for several years and then I bumped up to between 0.9 and 1.1 - varied between those two numbers for about the last 7 years. So I have probably 12+ years of PSA numbers.

I had my annual last week and my PSA was 2.5. I checked my number from last year (and my annual was almost exactly 1 year before) and it was 1.1. My doctor included a note that I should stop by the lab to repeat the test, but it was still well within normal range. A little digging told me normal range is not really below 4 anymore, but is really dependent on age and race and could be 2.5 for me. 3.5 at most. But still - I see his point that, one reading isn't reason to panic and also values can be far higher than that. Note: my PCP did not perform a DRE at my annual. So no information to help there, nor would it have impacted the results.

Then I realized I had a test from October that was also 1.1. So I realized my value went from 1.1 to 2.5 in 8 months. So while the value itself may not be particularly concerning as a single data point, in context of steady values of 1 for many years, then more than doubling in 8 months time, it may be.

I have tried to research what constitutes a sharp rise in PSA and i have come across PSA velocity, and my value is more than double the 0.75. But it is still difficult to find good information on the web about PSA values and PSA velocity and any relation to age and how they factor and when and if someone should be concerned.

Any thoughts about my increase in PSA and what it could mean? Is it fast? Is it too fast? Is 2.5 a number that could be concerning, especially when 8 months ago it was 1.1?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

VancouverIslandHiker | @vancouverislandhiker | Jun 29 8:26am

In reply to @melcanada "Stage 4 in spine Xtandi for a year Now 6th injection of Xofigo Psa up from..." + (show)

Mel-Canada , what sort of treatments have you gotten ? I know Canada wont buy Proton therapy machines . Its such a pity , very useful for radiation oncologists . In Canada yoru still using X-Rays for most radiation work . you have to get that darn PSA down though . Let me know a little more . Maybe I can shed some light Mel-Canada . James

melcanada | @melcanada | Jun 29 8:26am

Now June 2025
Need prayers Have done ALL the criteria for LU 477 or Pluvicto ( google it ) at PMHC and application is in from my CVH oncologists Need it ASAP else 6 months to live CONFIDENTIAL They even assigned me to palliative in home care if and when

PSA shot up 200 to 424 so last ADT ABIRATERONE was not working, hence LU 177 is last resort

CONFIDENTIAL PRAYERS PLEASE I feel and look great

VancouverIslandHiker | @vancouverislandhiker | Jun 29 8:27am

In reply to @dwheels8 "I think you should visit a urologist. Mine PSA went from 4.5 to 9.7 in 6..." + (show)

Very good advise . Would say the same thing ! Map a plan out with urologist . dont delay ! James

melcanada | @melcanada | Jun 29 1:31pm

In reply to @vancouverislandhiker "Mel-Canada , what sort of treatments have you gotten ? I know Canada wont buy Proton..." + (show)

PSA shot up 200 to 424 so last ADT ABIRATERONE was not working, hence LU 177 is last resort

PRAYERS PLEASE I feel and look great

chippydoo | @chippydoo | Jun 29 2:28pm

I went from 2 to 3.2 in two years and my primary suggest further testing. Urologist DRE found a nodule, ordered 4KBlood score and mri found cancer and biopsy confirmed high grade cancer at age 68. PSA rise only tells part of the story. I hear the newer PSE is a more accurate test. Best wishes for a good outcome.

jc76 | @jc76 | Jun 29 4:52pm

In reply to @spaceguy "Checking in a year later. To recap, last year at my annual, at the age of..." + (show)

@spaceguy

Checking in a year later. To recap, last year at my annual, at the age of 55 my PSA went from 1.1 the year before to 2.5 and I posted asking some questions. My PCP ordered a retest, and a couple weeks later it was 2.2. Both he and my urologist felt that this was an ok value and could just be my new baseline as I age. I have about 15 years of PSA values now, and for the first 13 it was between 0.7 and 1.3 - mostly at or below 1.0. The last 7 were solidly in the 1 to 1.1 range. I have been being treated for BPH for at least 12 of those years, so BPH is not causing a rise. Then last year it jumped to 2.5/2.2 in the two readings. This year at my annual it was 4.9. Retest took it to 5.0. %Free PSA value of 12. After retest PCP ordered a urology consult. Went to see a new urologist. (Mostly because I wanted to have the urologist in the same system as my PCP.) Got lucky because somebody must have cancelled at the this urologist and I got in to see him in 2 days. His next appointment was 3 weeks from now. Saw him yesterday and he said the number alone isn't necessarily concerning, but given the rise over two years, it was a possible cause for concern. He said we could track it for the next 6 to 12 months or we could do further testing. Upon DRE he said my prostate was not overly big, but that there was more firmness on one side than the other. He felt there was enough indication to do a biopsy. He also said he did not suspect prostatitis because it was likely that the PSA number would be much higher, plus I wasn't exhibiting other signs of prostatitis. He did ask if I would lose sleep if we continue to monitor, and I said so far I have not, but given the rise from 1.1 to 2.5 to 5 over 2 years, if I have to go another year, and take a test every few months to monitor, I probably would be stressed and lose sleep. So he ordered a TRUS guided prostate biopsy. My assumption of a TRUS guided prostate biopsy is that it will be needle entry for samples through the transperineal region, guided by the TRUS. But I guess I should confirm that, and that it is not a TRUS with needle attached to US probe. The procedure will be 2 weeks from yesterday, so I guess I am about 4 more weeks from a possible answer. I realize biopsies are not always 100% accurate (if they miss a cancerous spot), but it is better than a blood test only and waiting.

Jump to this post

@spaceguy
Did you work at KSC or CCAFS? Just asking because of I.D. spaceguy. I worked 14 years at Cape Canaveral Air Force Station.

I would like to comment that from your post it sounds like you have an outstaing urologist now. I read he was concerned about your mental health as well asking about you sleeping etc.

I wish all urologist and R/Os would be like yours. I am not complaining about mine they are outstanding but I read so many post that are not as lucky as you and I to have caring, experiences urologist, R/Os and PCPs treating them.

heavyphil | @heavyphil | Jun 29 5:02pm

In reply to @spaceguy "Checking in a year later. To recap, last year at my annual, at the age of..." + (show)

@spaceguy

Jump to this post

TRUS is Trans Rectal - You do NOT want that one! You want an MRI guided transperineal which can access more areas of the gland. Do not settle for the rectal - go elsewhere.
Your PSA rise is concerning after so many years in a certain range. Some aggressive forms of PCa can exhibit lower levels of PSA to begin with so the absolute number is not the issue - it’s the jump.
If you’re going to do this, you need to be certain that an aggressive cancer is not in the picture. You really need an MRI before the next steps can be taken; if anyone tells you that’s not the case, run like hell…
Phil

VancouverIslandHiker | @vancouverislandhiker | Jun 29 9:06pm

In reply to @melcanada "Now June 2025 Need prayers Have done ALL the criteria for LU 477 or Pluvicto (..." + (show)

Mel Canada - you have my prayers Sir . I wish you good health, peace and feeling / looking great. To you and your family. Gosh Bless . Keep the faith…. It matters!

dailyeffort | @dailyeffort | Jun 30 12:48am

In reply to @melcanada "Now June 2025 Need prayers Have done ALL the criteria for LU 477 or Pluvicto (..." + (show)

@melcanada you're in our prayers, as well. I'm happy for you to be looking and feeling well. Know that we are all here for you and pulling for that PSA to get kicked to the curb!
Bill